Treatment Of Diabetes Drugs Economic Studies

Objectives This study has two objectives: (1)To assess the short-time cost-effectiveness of roglizatone natrium in treating type 2 diabetic in order to price the drug; (2) To assess the long-time cost-effectiveness of roglizatone natrium in treating type 2 diabetic in order to provide evidence for treatment.Methods (1) A cost-effectiveness decision tree model was developed to assess, about 12-week period, the short-time economic effects. The trial group were treated with roglizatone natrium, and the control group were treated with roglizatone maleat. The two indicators of effectiveness were hemoglobin A(lc) and health-related quality of life overall score. (2) A Markov decision model was adapted to predict, over a 10-year period, the long-time cost-effectiveness with and without roglizatone natrium treatment. A stepwise approach was used to determine transition probabilities. First, the difference of decreased hemoglobin A(1c)between treatment with and without roglizatone natrium was obtained by multi-level Meta analysis. second, the baseline data(no roglizatone natrium) regarding risk on complication were based on the UKPDS substudy treated with metformin. Then, the transition probabilities was gained by the two steps in combination with Clark's report about complications of diabetes and hemoglobin A(lc) concentration.Results The short-time cost-effectiveness analysis showed that the cost of the treatment group was 5245 yuan for every reduced 1% hemoglobin A(lc) and 284 yuan for every reduced 1 cent HR-QoL overall score. The cost of the control group was 8225 yuan for every reduced 1% HbA₁c and 968 yuan for every reduced 1 cent HR-QoL overall score. Two analysis were done in the Markov decision model. The Markov cohort analysis showed that, Compared with treatment with no-roglizatone natrium, 81 persons were free of complications of diabetes and 27 were free of death for the cohort of 1000 people with treatment with roglizatone natrium. The Markov cost-effectiveness analysis showed that when the discount rate was 3%, the cost-effectiveness ratio of roglizatone natrium treatment was3438.24yuan/year with 17074.73yuan of incremental cost and 0.1157year of incremental effectiveness in comparision to the no- roglizatone natrium treatment. The incremental cost-effectiveness was 147636.03yuan/year. Results of probabilistic sensitivity analysis showed that the cost of roglizatone natrium treatment during 10 years would be vary between 19315.52yuan and 88887.73yuan. the average survival time of this cohort was 8.49 years for the treatment group, which was 0.11 year higher than that of no-roglizatone natrium treatment.Conclusions In this model, with its underlying assumptions and data, roglizatone natrium treatment was more economical than roglizatone maleat treatment for type 2 diabetes. Compared to no-roglizatone natrium treatment, treatment group seemed prolonging the life of type 2 diabetes. The Markov state transition model seemed to be a appropriate model to assess long-term pharmacoeconomics effects. This study could be used as methodology reference of pharmacoeconomics on the chronic diseases for Chinese pharmacoeconomist . The pharmarcoeconomics study in Chinese began just now. The baseline data about transition probability based on foreign research. So the findings of this study should be re-evaluated as soon as additional evidence becomes available from the clinical and economic studies.